Implementation of a national smoke-free prison policy: an economic evaluation within the Tobacco in Prisons (TIPs) study.

OBJECTIVE: To determine the cost-effectiveness of a smoke-free prison policy in Scotland, through assessments of the trade-offs between costs (healthcare and non-healthcare-related expenditure) and outcomes (health and non-health-related non-monetary consequences) of implementing the policy. DESIGN: A health economic evaluation consisting of three analyses (cost-consequence, cost-effectiveness and cost-utility), from the perspectives of the healthcare payer, prison service, people in custody and operational staff, assessed the trade-offs between costs and outcomes. Costs associated with the implementation of the policy, healthcare resource use and personal spend on nicotine products were considered, alongside health and non-health outcomes. The cost-effectiveness of the policy was evaluated over 12-month and lifetime horizons (short term and long term). SETTING: Scotland's national prison estate. PARTICIPANTS: People in custody and operational prison staff. INTERVENTION: Implementation of a comprehensive (indoor and outdoor) smoke-free policy. MAIN OUTCOME MEASURES: Concentration of secondhand smoke, health-related quality of life (health utilities and quality-adjusted life-years (QALY)) and various non-health outcomes (eg, incidents of assaults and fires). RESULTS: The short-term analyses suggest cost savings for people in custody and staff, improvements in concentration of secondhand smoke, with no consistent direction of change across other outcomes. The long-term analysis demonstrated that implementing smoke-free policy was cost-effective over a lifetime for people in custody and staff, with approximate cost savings of £28 000 and £450, respectively, and improvement in health-related quality of life of 0.971 QALYs and 0.262, respectively. CONCLUSION: Implementing a smoke-free prison policy is cost-effective over the short term and long term for people in custody and staff.

A two-state comparative implementation of peer-support intervention to link veterans to health-related services after incarceration: a study protocol.

BACKGROUND: Approximately 600,000 persons are released from prison annually in the United States. Relatively few receive sufficient re-entry services and are at risk for unemployment, homelessness, poverty, substance abuse relapse and recidivism. Persons leaving prison who have a mental illness and/or a substance use disorder are particularly challenged. This project aims to create a peer mentor program to extend the reach and effectiveness of reentry services provided by the Department of Veterans' Affairs (VA). We will implement a peer support for reentry veterans sequentially in two states. Our outcome measures are 1) fidelity of the intervention, 2) linkage to VA health care and, 3) continued engagement in health care. The aims for this project are as follows: (1) Conduct contextual analysis to identify VA and community reentry resources, and describe how reentry veterans use them. (2) Implement peer-support, in one state, to link reentry veterans to Veterans' Health Administration (VHA) primary care, mental health, and SUD services. (3) Port the peer-support intervention to another, geographically, and contextually different state. DESIGN: This intervention involves a 2-state sequential implementation study (Massachusetts, followed by Pennsylvania) using a Facilitation Implementation strategy. We will conduct formative and summative analyses, including assessment of fidelity, and a matched comparison group to evaluate the intervention's outcomes of veteran linkage and engagement in VHA health care (using health care utilization measures). The study proceeds in 3 phases. DISCUSSION: We anticipate that a peer support program will be effective at improving the reentry process for veterans, particularly in linking them to health, mental health, and SUD services and helping them to stay engaged in those services. It will fill a gap by providing veterans with access to a trusted individual, who understands their experience as a veteran and who has experienced justice involvement. The outputs from this project, including training materials, peer guidebooks, and implementation strategies can be adapted by other states and regions that wish to enhance services for veterans (or other populations) leaving incarceration. A larger cluster-randomized implementation-effectiveness study is planned. TRIAL REGISTRATION: This protocol is registered with clinicaltrials.gov on November 4, 2016 and was assigned the number NCT02964897 .

A Redox-Relay Heck Approach to Substituted Tetrahydrofurans.

An operationally simple and efficient strategy for the synthesis of substituted tetrahydrofurans from readily available cis-butene-1,4-diol is described. A redox-relay Heck reaction is used to rapidly access cyclic hemiacetals that can be directly reduced to afford the corresponding 3-aryl tetrahydrofuran. Furthermore, the hemiacetals can also serve as precursors to a range of disubstituted tetrahydrofurans, including the calyxolane natural products.

Control of response duration by delayed reinforcers: A systematic replication.

Three rats responded under schedules of delayed reinforcement in which sweetened condensed milk delivery depended upon lever-press durations exceeding or falling under a programmed value. For all rats, response durations increased compared to those emitted under a fixed-ratio 1 schedule when unsignaled delayed reinforcers were programmed for lever-press durations exceeding 1 s. For two of the rats, response durations also decreased when delayed reinforcer delivery was programmed for durations less than 1 s. Extinction reduced response rate, but did not affect response duration. Data suggest that the rate decreasing effects of unsignaled delayed reinforcers may be separated from the effects those reinforcers have on a targeted continuous dimension.

Histamine alters environmental place preference in planaria.

Although histamine functions as a punisher in vertebrate models, its potential aversive effects in invertebrates has gone largely unexamined. We investigated if planaria would develop conditioned place aversions to histamine. In the absence of any training, planaria readily move away from a light source. However, planaria will develop conditioned place preferences for lighted areas if those areas are paired with many of the same psychoactive drugs that produce conditioned place preferences in vertebrates. We confined planaria in the darkened side of a petri dish containing histamine, and they subsequently spent more time in the light than planaria confined initially to the darkened side of a petri dish containing fresh water only. This occurred whether we tested planaria individually or in groups. Pairing histamine with the light side of the petri dish had inconsistent effects, and histamine did not affect behavior under a motility assay. Although histamine altered the planaria behavior, it did not completely overcome the planaria's innate preference for darkened areas. Results add to a growing body of research showing continuity between planaria and vertebrates in the behavioral effects of psychoactive chemicals.

Response duration is sensitive to both immediate and delayed reinforcement.

We investigated the duration of lever pressing by rats when the delivery of appetitive reinforcers was contingent upon response duration. In the first experiment, response durations increased when duration requirements were imposed, and they decreased when duration requirements were removed. This effect occurred whether reinforcers were immediate or delayed by 8 s. In order to maintain the integrity of the delay intervals, reinforcer delivery was dependent upon both lever depression and release. In a second experiment, lever depression only and a response duration of at least 4 s were required for reinforcer delivery. Compared to immediate reinforcement conditions, delayed reinforcers increased both variability and the length of the maximum response durations. In a third experiment, immediate reinforcers were delivered contingent upon lever depression and release under a variety of duration requirements. Median lever-press durations tracked the contingencies rapidly. Across all three experiments, rats emitted numerous response durations that were too short to satisfy the reinforcer requirements, and bimodal distributions similar to those produced by differential reinforcement of low rate schedules were evident for most rats. In many aspects, response duration responds to reinforcement parameters in a fashion similar to rate of discrete responding, but an examination of this continuous dimension of behavior may provide additional information about environment-behavior relationships.

Effects of ethanol on negative phototaxis and motility in brown planarians (Dugesia tigrina).

The behavioral effects of ethanol in brown planarians were studied in four experiments. In the first two experiments, acute administrations of ethanol increased travel time in a dose-dependent fashion in individual planarians moving away from a light source. Orderly results were obtained using both within-subject and between-group designs. In a third experiment, ethanol dose was arranged by time rather than concentration. Ethanol increased travel time overall, but variability between subjects was considerable. In a final experiment, ethanol administration reduced motility and altered movement patterns in planarians in an open-field test. These experiments demonstrated that negative phototaxis by planarians may exhibit sufficient stability to allow for experimental determinations of dose-response curves utilizing both within-subject and between-subject designs.

Behavioral effects of delayed timeouts from reinforcement.

Timeouts are sometimes used in applied settings to reduce target responses, and in some circumstances delays are unavoidably imposed between the onset of a timeout and the offset of the response that produces it. The present study examined the effects of signaled and unsignaled timeouts in rats exposed to concurrent fixed-ratio 1 fixed-ratio 1 schedules of food delivery, where each response on one lever, the location of which changed across conditions, produced both food and a delayed 10-s timeout. Delays of 0 to 38 s were examined. Delayed timeouts often, but not always, substantially reduced the number of responses emitted on the lever that produced timeouts relative to the number emitted on the lever that did not produce timeouts. In general, greater sensitivity was observed to delayed timeouts when they were signaled. These results demonstrate that delayed timeouts, like other delayed consequences, can affect behavior, albeit less strongly than immediate consequences.

A comparison of resetting and nonresetting contingencies in progressive-duration schedules.

We compared two progressive schedules of reinforcement in which rats received access to sweetened condensed milk for depressing and holding down a response lever. Duration requirements increased after each reinforcer delivery in a manner similar to progressive-ratio schedules. Under one schedule, any response duration less than that required for reinforcement had no programmed consequences. Under the second schedule, the cumulative duration of all responses could meet the reinforcement criteria. Breaking points were consistently higher when all lever presses, regardless of duration, contributed to meeting the reinforcer requirements. Breaking points under both schedules increased when food deprivation was long enough to result in body-weight reductions, but the sensitivity of the schedules to brief periods of food deprivation was inconsistent. Under both schedules, food deprivation produced an increase in shorter durations, thus reducing the efficiency of responding.

Demand in rats responding under duration-based schedules of reinforcement.

In two experiments, demand curves were generated by exposing rats to a sequence of fixed-duration schedules in which the response requirement doubled each experimental session. Holding down the response lever for the requisite amount of time resulted in the delivery of sweetened condensed milk. Response durations shorter than those required for reinforcer delivery did not result in any programmed consequences, nor were cumulative durations across multiple presses applied towards the duration requirements. The number of reinforcer deliveries decreased as a function of reinforcer requirements. Reinforcer delays alone also decreased consumption, but to a lesser extent than increasing duration requirements. Results are congruent with previous research demonstrating that parameters of reinforcement schedules may have similar effects on both continuous and discrete dimensions of operant behavior. Hursh and Silberberg's (2008) exponential demand equation provided a good fit for several of the data sets.

A progressive-duration schedule of reinforcement.

We describe a schedule of reinforcement involving systematic, within-session increases in response-duration requirements. Rats received access to appetitive reinforcers for depressing and holding down a response lever. Duration requirements increased after each reinforcer delivery. Sessions ended when reinforcement criteria were unmet for a period of ten minutes. Breaking points, defined as the terminal duration requirement in effect prior to the end of the session, stabilized when environmental conditions were held constant. Breaking points were sensitive to manipulations of both food deprivation and reinforcer quality. Analogous to progressive-ratio schedules, progressive-duration schedules may provide an assay for measuring the amount of behavior an organism will emit for a given reinforcer under current motivational conditions.

Acquisition of operant behavior in rats with delayed reinforcement: A retractable-lever procedure.

Experimentally naïve rats acquired lever pressing with delayed reinforcement when the immediate programmed consequence for lever pressing was the simultaneous retraction of two identical levers. Presses on one lever also produced access to sweetened condensed milk after a delay of 10s following retraction. Presses on the second lever resulted in retraction only. Lever retraction prevented the possibility of adventitious reinforcement of contacting the operanda during the reinforcement delays. Several measures indicated that the delayed reinforcers strengthened behavior. The majority of responses for all rats were on the lever that initiated reinforcer delivery. Responding for seven out of eight rats decreased during a subsequent extinction phase in which retraction was the only consequence arranged for lever pressing. Responding recovered rapidly when food reinforcement was available again. Furthermore, when contingencies on the two levers were switched, rats allocated their behavior accordingly, showing control by the delayed reinforcers.